Pediatrics
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Comparative Study
Changing epidemiology of bacteremia in infants aged 1 week to 3 months.
Bacteremia in young infants has remained an important ongoing concern for decades. Despite changes in prenatal screening and infant immunizations, the current epidemiology of this problem has received little attention. ⋯ Our study indicates bacteremia in young infants occurs infrequently and in only 2.2% of those who had a blood culture drawn. On the basis of the epidemiology of pathogens found in this large cohort, these data suggest a change in currently recommended presumptive antibiotic coverage in 1-week to 3-month-old infants with suspected bacteremia.
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There are limited data on the epidemiology of serious injuries due to physical abuse of children. ⋯ This is the first study to provide national US data on the occurrence of serious injuries due to physical abuse in hospitalized children. Data from the 2006 Kids' Inpatient Database on hospitalizations due to serious physical abuse can be used to track trends over time and the effects of prevention programs on serious physical abuse.
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Randomized Controlled Trial Comparative Study
Hemodynamic effects of delayed cord clamping in premature infants.
Delayed cord clamping (DCC) has been advocated during preterm delivery to improve hemodynamic stability during the early neonatal period. The hemodynamic effects of DCC in premature infants after birth have not been previously examined. Our objective was to compare the hemodynamic differences between premature infants randomized to either DCC or immediate cord clamping (ICC). ⋯ DCC in premature infants is associated with potentially beneficial hemodynamic changes over the first days of life.
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Randomized Controlled Trial Comparative Study
Effect of repeated dietary counseling on serum lipoproteins from infancy to adulthood.
As atherosclerosis is a lifelong process, prevention of exposure to its risk factors should start at an early age. Our aim was to study the influences of repeated low saturated fat dietary counseling on dietary intakes and lipoprotein measures from infancy to adulthood. ⋯ Repeated dietary counseling is effective in decreasing saturated fat intake and serum LDL-C values from infancy until 19 years of age in both genders. In boys, significant intervention effects are evident in various lipoprotein measures, indicating a more favorable lipid profile in the counseling group.
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Comparative Study
Community asthma initiative: evaluation of a quality improvement program for comprehensive asthma care.
The objective of this study was to assess the cost-effectiveness of a quality improvement (QI) program in reducing asthma emergency department (ED) visits, hospitalizations, limitation of physical activity, patient missed school, and parent missed work. ⋯ The program showed improved health outcomes and cost-effectiveness and generated information to guide advocacy efforts to finance comprehensive asthma care.